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OBJECTIVE To systematically evaluate the efficacy and safety of thalidomide combined with aclacinomycin, granulocyte colony-stimulating factor and cytarabine (CAG) regimen in the treatment of elderly patients with acute myeloid leukemia (AML). METHODS CNKI, Wanfang data, VIP, Sino Med, PubMed, Embase, the Cochrane Library and Web of Science were searched comprehensively from the inception to Aug. 27th, 2023. Randomized controlled trials (RCTs) about thalidomide combined with CAG regimen (trial group) versus CAG regimen (control group) in the treatment of elderly AML patients were collected, and RevMan 5.3 software was used for meta-analysis of included studies. RESULTS Finally, 7 RCTs were included, with a total of 601 patients, including 307 patients in the trial group and 294 patients in the control group. Meta-analysis results showed that the trial group was superior to the control group in enhancing the overall response rate [Z=4.75, P<0.000 01, OR=2.80, 95%CI (1.83,4.28)], complete remission rate [Z=2.82, P=0.005, OR=1.61, 95%CI (1.16, 2.25)], and improving platelet count [Z=2.70, P=0.007, MD=64.02, 95%CI (17.53, 110.51)], vascular endothelial growth factor [Z=13.63,P<0.000 01, MD=-65.17, 95%CI(-74.54, -55.80)], vascular endothelial growth factor receptor [Z=12.03, P< 0.000 01, MD=-499.01, 95%CI (-580.31, -417.71)] and basic fibroblast growth factor [Z=4.17, P<0.000 1,MD=-0.23, 95%CI(-0.35, -0.12)]. And there was no statistical difference between the trial group and the control group in the incidence of adverse drug reaction [Z=0.99, P=0.32, OR=0.52, 95%CI(0.14,1.89)], nausea and vomiting [Z= 1.06, P=0.29, OR=0.66, 95%CI (0.30,1.43)], constipation or diarrhea [Z=0.92, P=0.36, OR=0.65, 95%CI(0.26, 1.63)], drowsiness [Z=1.38, P=0.17, OR=0.57, 95%CI(0.26, 1.27)] or myelosuppression [Z=0.88,P=0.38,OR=0.68,95%CI(0.28, 1.62)]. CONCLUSIONS The combination of thalidomide and CAG regimen in the treatment of elderly AML patients can significantly improve clinical efficacy and has high safety.
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Objective:To investigate and analyze the cognition of medical staff on medical research ethics in a grade A tertiary hospital, combined with the current situation of practice, to provide a basis and ideas for exploring new educational models of medical research ethics.Methods:Medical staff in a grade A tertiary hospital were investigated through an anonymous questionnaire to collect and analyze their cognition of medical research ethics and the current situation of practice.Results:There were statistically significant differences ( P<0.05) in the cognition of medical research ethics among different educational backgrounds, majors, and professional titles. The survey results showed that doctors, medical staff with graduate degrees or above, and senior title personnel had better cognition of medical research ethics than nurses, medical staff with bachelor degrees or below, and intermediate or junior title personnel. Conclusions:The medical staff's cognition and practice of medical research ethics are still insufficient. Hospitals should pay attention to the education of medical research ethics and enrich the content and form of training to improve the ethical literacy of medical personnel.
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Objective:To explore the clinical characteristics of patients infected with 2019 novel coronavirus (2019-nCoV) Omicron variant in Zhuhai City.Methods:A retrospective study was conducted to compare the clinical characteristics of patients infected with 2019-nCoV Omicron variant (Omicron variant group, 39 cases) from January 13 to January 25, 2022, and those infected with 2019-nCoV non-Omicron variant (non-Omicron variant group, 98 cases) from January 17 to February 17, 2020, in the Fifth Affiliated Hospital of Sun Yat-sen University. Statistic methods were used by Mann-Whitney U test, chi-square test and Fisher exact probability test. Results:Among adults, the age of 21 patients in Omicron variant group was younger than that of 93 patients in non-Omicron variant group (34.0(26.0, 40.5) years vs 50.0(36.0, 62.0) years, Z=-3.81, P<0.001). Patients with underlying diseases in Omicron variant group were fewer than those in non-Omicron variant group (4.8%(1/21) vs 31.2%(29/93), χ2=6.17, P=0.013). The clinical classification of the Omicron variant group was mainly mild (71.4%(15/21)) or common type (28.6%(6/21)), while the non-Omicron variant group was dominated with common type (57.0%(53/93)) and severe type (23.7%(22/93)), and the clinical classification of the two groups had statistically difference ( χ2=31.79, P<0.001). The time of positive nucleic acid in Omicron variant group was longer than that in non-Omicron variant group (14.0(10.5, 16.5) d vs 8.5(4.0, 12.0) d, Z=-3.56, P<0.001). The proportion of pneumonia in Omicron variant group was less than that in non-Omicron variant group (28.6%(6/21) vs 86.0%(80/93), χ2=30.52, P<0.001). Differences were all statistically significant. There was no significant difference of the clinical characteristics in pediatric patients, but the proportion of children infected with 2019-nCoV Omicron variant was significantly higher than that infected with 2019-nCoV non-Omicron variant (46.2%(18/39) vs 5.1%(5/98), χ2=33.65, P<0.001). Conclusions:Adults infected with 2019-nCoV Omicron variant in Zhuhai City present with milder clinical symptoms, less proportion of pneumonia, but the time of positive nucleic acid is longer. The clinical characteristics of children infected with 2019-nCoV Omicron variant are not specific, while the proportion of children infected with 2019-nCoV Omicron variant is significantly higher.
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Objective:To analyze the clinical characteristics of patients infected with 2019-nCoV Omicron variants BA.1 and BA.2 in Zhuhai city.Methods:A retrospective study was conducted to compare clinical characteristics of patients infected with 2019-nCoV Omicron variants BA.1 and BA.2, who were admitted in the Fifth Affiliated Hospital of Sun Yat-sen University during January 13 to March 8 2022. The Mann-Whitney U-test or Kruskal-Wallis H test was used for quantitative data, and the χ2 test or Fisher’s exact test was used for qualitative data. Results:Among 122 patients infected with the Omicron variant, there was 79 adults (BA.1 23 cases, BA.2 56 cases) and 43 children (BA.1 19 cases, BA.2 24 cases). In adults, patients infected with BA.2 sub-variant had a higher baseline viral loads at admission than BA.1 infected patients [7.64(6.92, 8.55) lg copies/mL vs. 6.64(6.04, 7.34) lg copies/mL; Z=-3.022, P=0.003]; compared to BA.1 patients, BA.2 patients had a higher proportion of mild and asymptomatic cases and a lower proportion of common infection cases ( χ2=8.052, P=0.012); the proportion of patients with pneumonia imaging changes in BA.1 patients was higher than that in BA.2 infected patients [(6/23, 26.1%) vs. (2/56, 3.6%); χ2=6.776, P=0.009). In children, the rate of fever in BA.2 group was higher than that in BA.1 group [(16/24, 66.7%) vs. ( 5/19, 26.3%); χ2=6.910, P=0.009); the proportion of patients with reduced lymphocyte counts in BA.2 group was higher than that in BA.1 group [(17/24, 70.8%) vs.(1/19, 5.3%); χ2=18.734, P<0.001). Compared with adult cases, children with BA.2 sub-variant infection had higher fever rate [(16/24, 66.7%) vs. (19/56, 33.9%); χ2=7.317, P=0.007). The viral loads of daily nasal swabs in BA.2 infected patients increased first and then decreased in both adults and children, with a greater decrease than BA.1 during the first two weeks. Conclusions:Compare with 2019-nCoV Omicron variant BA.1, BA.2 has a higher baseline viral loads in adults, which means much more contagious in the early stages. But the viral load drops faster in BA.2 infected patients. In children, BA.2 patients are more likely to have fever and reduced lymphocyte counts, which indicates that the prevention and control of 2019-nCoV Omicron sub-variant BA.2 is more difficult.
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Objective To explore whether inhibiting autophagy can enhance the sensitivity of photothermal treatment under mild photothermal conditions. Methods CQ@PLGA@PDA NPs were prepared by an improved double emulsification method and a PDA-based surface modification method. After basic characterization, CCK-8 method was used to detect the cytotoxicity of nanoparticles; the near-infrared laser irradiation nanoparticle solution was used to detect the heating effect; CCK-8 method and live-dead cell staining were used to detect the killing effect of tumor cells; Western blot was used to detect the expression of autophagy-related proteins. Results The CQ@PLGA@PDA NPs were successfully prepared, with a particle size of 253.10±2.39 nm, a zeta potential of -22.57±0.80 mV, uniform particle size and good dispersion. The temperature of nanoparticle solution increased to 45℃ after the near-infrared laser irradiation for 10 min. CQ@PLGA@PDA NPs had no obvious toxicity to cells. The survival rates of breast cancer cell MDA-MB-231 and mouse embryonic fibroblast NIH-3T3 cell were above 95%. The inhibition of autophagy under mild photothermal conditions could improve the sensitivity of photothermal therapy. Conclusion The prepared CQ@PLGA@PDA NPs have good photothermal performance and high biological safety; by inhibiting autophagy, they can effectively kill tumor cells under mild photothermal conditions(< 50℃).
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Preventing and mitigating major risk exposure is an important task for modern countries to maintain sustained and healthy economic development and overall social stability. In this manuscript, the authors introduced Israel′s current medical and health care risk prevention system, including the regional health emergency response coordination mechanism, hospital′s external emergency rescue capacity building and hospital′s internal security system. Israel′s risk prevention system has been tested by wars and terrorist attacks, as well as many infectious diseases outbreaks. Thus the authors expected that its successful experiences can be introduced as a reference for improving China′s medical and health care risk prevention system.
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Objective@#To evaluate the changes in the endoplasmic reticulum stress in the spinal cord of rats with diabetic neuropathic pain (DNP).@*Methods@#Clean-grade healthy male Sprague-Dawley rats, aged 8 weeks, weighing 120-160 g, were fed a high-fat and high-glucose diet for 8 weeks, then diabetes mellitus was induced by intraperitoneal streptozotocin 35 mg/kg and confirmed by blood glucose level >16.7 mmol/L 3 days later.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at day 14 after injection.The establishment of DNP model was considered successful when MWT and TWL were lower than 85% of the baseline value.Fifteen rats in which the DNP model was successfully established served as DNP group, 15 rats in which the DNP model was not successfully established served as non-NDNP group (NDNP), and another 15 normal rats were selected and served as control group (group C). The MWT and TWL were measured at 3, 7 and 14 days after successful establishment of the model.The rats were then sacrificed, and the lumbar enlargement segments (L4-6) of the spinal cord were harvested to detect the expression of inositol-requiring enzyme-1α, phosphorylated JNK (p-JNK) and Beclin1 by Western blot.@*Results@#Compared with C and NDNP groups, the MWT was significantly decreased and the TWL was shortened at 3, 7 and 14 days after successful establishment of the model, and the expression of inositol-requiring enzyme-1α, p-JNK and Beclin1 was up-regulated in DNP group (P<0.05).@*Conclusion@#The mechanism of development and maintenance of DNP may be related to aggravated endoplasmic reticulum stress in the spinal cord and to autophagy induced by up-regulated expression of p-JNK in rats.
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Objective To evaluate the changes in the endoplasmic reticulum stress in the spinal cord of rats with diabetic neuropathic pain (DNP).Methods Clean-grade healthy male Sprague-Dawley rats,aged 8 weeks,weighing 120-160 g,were fed a high-fat and high-glucose diet for 8 weeks,then diabetes mellitus was induced by intraperitoneal streptozotocin 35 mg/kg and confirmed by blood glucose level >16.7 mmol/L 3 days later.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at day 14 after injection.The establishment of DNP model was considered successful when MWT and TWL were lower than 85% of the baseline value.Fifteen rats in which the DNP model was successfully established served as DNP group,15 rats in which the DNP model was not successfully established served as non-NDNP group (NDNP),and another 15 normal rats were selected and served as control group (group C).The MWT and TWL were measured at 3,7 and 14 days after successful establishment of the model.The rats were then sacrificed,and the lumbar enlargement segments (L4-6) of the spinal cord were harvested to detect the expression of inositol-requiring enzyme-1 α,phosphorylated JNK (p-JNK) and Beclin1 by Western blot.Results Compared with C and NDNP groups,the MWT was significantly decreased and the TWL was shortened at 3,7 and 14 days after successful establishment of the model,and the expression of inositol-requiring enzyme-1α,p-JNK and Beclin1 was up-regulated in DNP group (P<0.05).Conclusion The mechanism of development and maintenance of DNP may be related to aggravated endoplasmic reticulum stress in the spinal cord and to autophagy induced by up-regulated expression of p-JNK in rats.
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AIM: To investigate the changes of alkaloid in Rhizorrm Coptidis and Fructus Evodiae before and after combination. METHODS: The content of berberine hydrochloride,palmatine hydrochloride,jatrorrhizine hydrochloride in Rhizoma Coptidis and Fructus Evodiae before and after combination were determined by TLCS.RESULTS : After combination of Rhizoma Coptidis and Fructus Evodiae,contents of berberine hydrochioride,palmatine hydrochloride,jatrorrhizine hydrochloride significantly reduced,among which the reduction of berberine hydrochloride was more obvious.CONCLUSION: In decoction,Fructus Evodiae appears to restrict the alkaloid from Rhizoma Coptidis in order to lower the side effect of Rhizoma Coptidis.
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OBJECTIVE: Adopting methods of cell culture to explore the effects and mechanisms of Jianpi Bushen Huoxue Prescription (JPBSHXP), a traditional Chinese compound herbal medicine for strengthening spleen, reinforcing kidney and activating blood circulation, in inhibiting hematopoietic cells apoptosis in a mouse model of aplastic anemia (AA). METHODS: Blood serum of AA mice was made from an AA mouse model. Blood serums containing different traditional Chinese compound herbal medicine were made from rats after intragastric administration of JPBSHXP and its related decoctions, respectively. Bone marrow cells of normal mice were incubated by these blood serums for 24 hours, respectively. The apoptosis of the bone marrow cells were assayed by flow cytometry and transmission electron microscopy (TEM). RESULTS: It was indicated that the bone marrow cells of normal mice incubated with blood serum of AA mice displayed typical apoptosis. The apoptosis rates of bone marrow cells of the AA mice incubated by blood serum containing different traditional Chinese herbal medicine were decreased. The effect of Bushen (reinforcing kidey) Recipe was better than Jianpi (strengthening spleen) Recipe and Huoxue (activating blood circulation) Recipe, while the effect of JPBSHXP was the best. TEM results showed that the effect of Bushen Recipe was better than that of the Jianpi Recipe and the Huoxue Recipe, while the effect of JPBSHXP was the best. CONCLUSION: JPBSHXP and its related decoctions can significantly decrease the apoptosis rate of bone marrow mononuclear cells of the AA mice. It is inferred that JPBSHXP can promote bone marrow hematogenesis.
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OBJECTIVE: To observe the clinical effect of Shengxueling Granule (SXLG) in treating idiopathic thrombocytopenic purpura (ITP), and to study its possible mechanism. METHODS: Eighty-six cases of ITP were divided into two groups randomly. Fifty-six cases in the treatment group were treated with SXLG, a traditional Chinese medicine, and 30 cases administered with Western medicine (prednisone) were taken as control. Patients in each group took drugs for three months and were under follow-up observation. RESULTS: In SXLG-treated group, the total effective rate in 3 months was 85.71%, similar to 83.33% in prednisone-treated group (P>0.05), while the total effective rate in 6 months in the SXLG-treated group was 91.07%, higher than 53.33% of the prednisone-treated group (P<0.01), and no obvious side-effects were observed. The patients' bleeding was alleviated or stopped, and their general condition was improved. And the blood platelet count (BPC) was increased, the platelet associated immunoglobulin (PAIg) and interleukin-4 (IL-4) were markedly dropped, the level of natural killer cells activity (NKCA) increased, and the rate of T lymphocyte subsets gradually returned to normal level. Megakaryocytes tended toward maturation on bone marrow smear after SXLG treatment. All differences above were statistically significant. CONCLUSION: SXLG is an effective and safe medicine for ITP. It can regulate the cellular immunity, inhibit the platelet antibody to reduce the destruction of the platelet and to increase the number of platelet, promote the differentiation and maturation of megakaryocyte, facilitate the production and release of platelet, lower the fragility of capillary, and prevent the hemorrhagic tendency.
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AIM:To investigate the changes of alkaloid in Rhizoma Coptidis and Fructus Evodiae before and after combination.METHODS:The content of berberine hydrochloride,palmatine hydrochloride,jatrorrhizine hydrochloride in Rhizoma Coptidis and Fructus Evodiae before and after combination were determined by TLCS.RESULTS:After combination of Rhizoma Coptidis and Fructus Evodiae,contents of berberine hydrochloride,palmatine hydrochloride,jatrorrhizine hydrochloride significantly reduced,among which the reduction of berberine hydrochloride was more obvious.CONCLUSION:In decoction,Fructus Evodiae appears to restrict the alkaloid from Rhizoma Coptidis in order to lower the side effect of Rhizoma Coptidis.